NPI | 1720351034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 14297) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 004564) |
225100000X Physical Therapist (Licence: FL 26829) | |
Enumeration Date | 2012-02-16 |
Last Update Date | 2023-12-26 |